Inspection on 15/10/08 for Adderley House

This inspection was carried out on 15th October 2008.

CSCI found this care home to be providing an Good service.

The inspector found no outstanding requirements from the previous inspection report, but made 3 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Adderley House 10/05/06

Adderley House 30/01/06

Adderley House 05/09/05

Adderley House 04/03/05

Adderley House 21/09/04

Extracts from inspection reports are licensed from CQC, this page was updated on 04/12/2008.

Inspecting for better lives Key inspection report Care homes for older people Name: Address: Adderley House 23 London Road Long Sutton Lincs PE12 9EA     The quality rating for this care home is:   two star good service A quality rating is our assessment of how well a care home, agency or scheme is meeting the needs of the people who use it. We give a quality rating following a full assessment of the service. We call this a ‘key’ inspection. Lead inspector: Alison Jessop     Date: 1 5 1 0 2 0 0 8 This is a report of an inspection where we looked at how well this care home is meeting the needs of people who use it. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. the things that people have said are important to them: They reflect This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Copies of the National Minimum Standards – Care Homes for Older People can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop The Commission for Social Care Inspection aims to: · · · · Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Our duty to regulate social care services is set out in the Care Standards Act 2000. Care Homes for Older People Page 2 of 24 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report CSCI General public 0870 240 7535 (telephone order line) Copyright © (2008) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. www.csci.org.uk Internet address Care Homes for Older People Page 3 of 24 Information about the care home Name of care home: Address: Adderley House 23 London Road Long Sutton Lincs PE12 9EA 01406364918 01406363981 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: Adderley House Ltd care home 40 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 old age, not falling within any other category Additional conditions: Date of last inspection Brief description of the care home Adderley House Retirement Home is a detached, listed building with a large, purpose built annexe, set in its own grounds and part of a complex, which includes Adderley House Care Home with Nursing. The home is registered to provide personal care for up to 40 people over the age of 65 years. The home is situated close to the small market town of Long Sutton, which has a range of shops and facilities. The nearest sizeable town is Spalding about 12 miles away. There is accommodation for 14 people in the main building with a further 26 people in 15 self contained flats in an adjoining annexe. Each flat comprises one or two bedrooms, shower or bathroom and kitchenette. The home also provides one day care place. The fees at the inspection ranged from 315 pounds to 422 pounds per week. Extras are for hairdressing, toiletries and personal newspapers and magazines. A copy of the Service User Guide and Statement of Purpose can be gained from the manager. The date of the previous Key Inspection was 25th October 2006. 0 Over 65 40 Care Homes for Older People Page 4 of 24 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: two star good service Choice of home Health and personal care Daily life and social activities Complaints and protection Environment Staffing Management and administration peterchart Poor Adequate Good Excellent How we did our inspection: One Regulatory Inspector carried this unannounced inspection out over one day. The manager was not at the service on the day of the inspection as she was attending a conference. The deputy manager was available throughout the inspection to answer questions. We spoke to eight residents to gain feedback. We also looked closely at the care of three residents in the home. This process is called case tracking. We speak to the resident and observe their care. We look at their care plan and other records. We also looked at their medication and any other documentation in relation to their care. We gained feedback from two care staff. We also gained advice from the Lincolnshire Care Homes for Older People Page 5 of 24 Fire Safety Service in relation to a concern raised about doors. A telephone call was made to the registered manager following the site visit and information was taken from the Annual Quality Assurance Assessment. This is a selfassessment, which is requested each year by CSCI. What the care home does well: What has improved since the last inspection? What they could do better: If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details set out on page 4. Care Homes for Older People Page 7 of 24 The report of this inspection is available from our website www.csci.org.uk. You can get printed copies from enquiries@csci.gsi.gov.uk or by telephoning our order line –0870 240 7535. Care Homes for Older People Page 8 of 24 Details of our findings Contents Choice of home (standards 1 - 6) Health and personal care (standards 7 - 11) Daily life and social activities (standards 12 - 15) Complaints and protection (standards 16 - 18) Environment (standards 19 - 26) Staffing (standards 27 - 30) Management and administration (standards 31 - 38) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Older People Page 9 of 24 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them and the support they need. People who stay at the home only for intermediate care, have a clear assessment that includes a plan on what they hope for and want to achieve when they return home. People can decide whether the care home can meet their support and accommodation needs. This is because they, or people close to them, have been able to visit the home and have got full, clear, accurate and up to date information about the home. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between them and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. There is a robust admission procedure which ensures that peoples needs can be met. Evidence: Prospective residents are assessed prior to being accepted for accommodation. The care plan is formed following a thorough needs assessment of the prospective resident. Information is also gained from other professionals such as GPs, nurses and social workers. This service does not provide Intermediate Care. Care Homes for Older People Page 10 of 24 Health and personal care These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s health, personal and social care needs are met. The home has a plan of care that the person, or someone close to them, has been involved in making. If they take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it, in a safe way. People’s right to privacy is respected and the support they get from staff is given in a way that maintains their dignity. If people are approaching the end of their life, the care home will respect their choices and help them feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The residents in the home receive good person centered care by a kind and dedicated staff team. Evidence: Each resident has an individual care plan which is based upon information given by the resident, their relatives or representatives. The care plans are reviewed on a regular basis. Care plans include information on individual preferences and on how to maintain the independence of the resident. Senior carers are responsible for reviewing and maintaining care plans. An incident was notified to CSCI as a resident had climbed out of her flat window onto the corridor. The resident was not injured however upon speaking to other residents living in the flats it was discovered that staff lock the front door to every flat at night in order to maintain their security. The residents spoken to said that they felt safer having the doors locked. The deputy manager stated that the residents have a key to get out however on the day that the resident had climbed out of the window she had Care Homes for Older People Page 11 of 24 Evidence: been unable to use her key as she had become very confused. On inspection of three of the residents care plans there was no risk assessment to support this practice. The residents mental capacity had not been assessed and the circumstances for using this practice had not been recorded. One care plan we looked at had a mental capacity assessment that had been signed by the resident. This resident had full capacity to make decisions and choices. Three other care plans observed did not have completed capacity assessments. Residents receive health care services as required. The GP and District nurses visit the home on a regular basis. No one has developed pressure sores in the home. Residents looked well cared for and feedback about the care was good. One resident said I am quite happy here, they are very kind, I get well looked after. All residents spoken to said they are treated in a dignified manner. Procedures relating to medication are satisfactorily maintained. Care Homes for Older People Page 12 of 24 Daily life and social activities These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives. They are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. People have nutritious and attractive meals and snacks, at a time and place to suit them. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Residents have access to stimulating social events and are assisted to feel part of the local community. The food is wholesome, freshly cooked and nicely presented. Evidence: There are various activities available which are displayed on the notice board in the hallway. An Occupational Therapist visits the home twice a week to orgnaise various activities such as card making, bingo and word games. Some of residents were taken on holiday to Skegness. One resident said I have been to Skegness for a week, the carers were wonderful, they took me all around in the wheelchair, we had a great time. Religious services are held and entertainment is also provided. There is a Christmas and New Year party, cheese and wine evening for residents and their relatives. Other trips out into the community are arranged and each year the home has a Christmas Fayre, summer garden fete and Easter parade where members of the community are welcome to visit. All money raised goes to the resident comfort fund which pays for activities. Care Homes for Older People Page 13 of 24 Evidence: One resident said I like to stay independent, I deliver the post to all the other residents in the flats and I like to dust my flat myself, it keeps me busy. The food is freshly cooked and residents said that they get plenty of choice. Feedback about the food was very good. One resident said I think the food is wonderful. On the day of the inspection the lunch was roast chicken, mash and fresh veg followed by sponge and custard. Care Homes for Older People Page 14 of 24 Complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them know how to complain. Any concern is looked into and action taken to put things right. The care home safeguards people from abuse and neglect and takes action to follow up any allegations. People’s legal rights are protected, including being able to vote in elections. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Residents can be confident that their complaints will be listened to and action taken to resolve the complaints in a timely manner. Evidence: There has been one complaint made which has been fully resolved. The safeguarding team carried out an investigation in relation to this allegation and abuse was not substantiated. One safeguarding investigation was carried out where a carer had not given the appropriate care to a resident The member of staff was dismissed and a referral made to POVA. The manager followed the correct procedure when dealing with this incident in order to safeguard the residents. Staff have recently completed training on Safeguarding Adults. Care Homes for Older People Page 15 of 24 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. This is what people staying in this care home experience: Judgement: People using this service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Adderley House provides a homely environment to the residents and the small lounges enable people to live in a non-institutional environment. Some areas of the home create challenges to the health and safety of the residents which are not always easy to remedy due to the listed status of the building. Evidence: The home is currently being developed and further bedrooms are being added along with a new lounge. As parts of the home are a listed building, there are some restrictions on how much can be developed. Each residents bedroom looked homely and residents are consulted about how they would like their bedrooms re-decorated. Currently the main lounge in the home can become overcrowded however residents are given another option to use the small lounge on the first floor. Some of the residents who live in the flats prefer to use their own lounges. The small lounge on the first floor is very homely and residents were sitting around the dining table chatting. A new key pad system has been added to the main front doors to the home. Residents who live in the flats have their front door locked by staff at night. The residents therefore need to use a key to get out. One resident climbed out of a window to get out and another resident spoken when asked how he would get out of the flat in an Care Homes for Older People Page 16 of 24 Evidence: emergency stated I would have to climb out of the window. Not all of the residents spoken to were aware that they have a key and said that they rely upon the staff to let them out. Although the managers and staff are very aware of the residents needs, the overall risk management process has not been formally risk assessed. The main kitchen has had a new floor covering however some of the doors on the units have fallen off or are hanging off. Areas of the work surface are scorched. The home looked clean and no malodours were detected. Care Homes for Older People Page 17 of 24 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable to care for them. Their needs are met and they are cared for by staff who get the relevant training and support from their managers. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The service has a stable staff team who provide consistent, good quality care to the people who live there. Evidence: Residents said that they are assisted in a timely manner and dont have to wait long periods of time for staff to help them. There are five to six care staff on duty in the morning and five care staff plus a kitchen assistant on duty in the afternoon. Staff spoken to said that they receive adequate training to carry out their job safely. One member of staff had completed a course on dementia with the Alzheimers Society and another a comprehensive course on medication administration. Recruitment records could not be inspected as manager was not available. There has not been any previous concerns about recruitment procedures and therefore this standard will be fully inspected at the next key inspection. Staff spoken to also confirmed that they were subject to criminal record disclosures. Care Homes for Older People Page 18 of 24 Management and administration These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is led and managed appropriately. People control their own money and choose how they spend it. If they or someone close to them cannot manage their money, it is managed by the care home in their best interests. The environment is safe for people and staff because appropriate health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately with an open approach that makes them feel valued and respected. The people staying at the home are safeguarded because it follows clear financial and accounting procedures, keeps records appropriately and ensures their staff understand the way things should be done. They get the right care because the staff are supervised and supported by their managers. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home is well managed however the listed building status of the home creates some health and safety issues which are not easily resolved. Evidence: The manager has worked at the home for 19 years and there is a stable staffing team. The manager has a Registered Managers Award. There is also a deputy manager who has an NVQ 2 and the service now has administration support three days a week. The Annual Quality Assurance Assessment which is a self assessment of the service, was returned to CSCI within the required timescale. Quality audits are carried out where surveys are given to the residents to feedback. Formal residents meetings are not held as the deputy manager said that residents are not keen to attend these. Staff meetings are held once a month. There is a safe system in place for the storage and recording of residents personal Care Homes for Older People Page 19 of 24 Evidence: finances. Two residents choose to manage their own finances. An Immediate requirement was made about lack of window restrictors on first floor. Two residents have climbed out of ground floor windows previously. Risk assessments had not been carried out for these windows. Since then the manager stated that the provider is visiting the service to look at how the windows can be made safer. A fire safety inspection was carried out in April 2008. A notice was served by the fire officer as several areas did not conform to fire safety regulations. Some of the requirements have since been met however the service has requested an extension on the timescale. The manager said that this is due to issues with the building being listed. Care Homes for Older People Page 20 of 24 Are there any outstanding requirements from the last inspection? Yes £ No R Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards No. Standard Regulation Requirement Timescale for action Care Homes for Older People Page 21 of 24 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action 1 38 13 You must carry out a risk assessment on all first floor windows and take action to ensure the safety of the residents. There has been two incidents where residents have climbed out windows. You must prevent this from happening again in the future in order to protect the safety of the residents. 25/10/2008 Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action 1 7 13 Risk assessments must include an action plan on how to reduce or eliminate the risk. This is in order to protect the safety of the residents. 15/11/2008 2 7 13 You must ensure that a care plan and risk assessment is in place for the practice of locking residents flat doors at night. To ensure that the safety of the residents is considered and as far as possible risks 15/11/2008 Care Homes for Older People Page 22 of 24 eliminated and to record the rationale for locking the doors. 3 19 23 The main kitchen units and work surfaces must be replaced. The kitchen is not in a good state of repair. 23/10/2009 Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No. Refer to Standard Good Practice Recommendations 1 7 Staff need to record or show evidence that the resdients mental capacity has been considered when reviewing their care. It is recommended that a more suitable door locking system is fitted to the front door of the flats which ensures the safety of the residents. 2 19 Care Homes for Older People Page 23 of 24 Helpline: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. 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